Pregnancy Safe with Epilepsy

The guidelines developed by the American Academy of Neurology and the American Epilepsy Society recommend women with epilepsy avoid taking the drug valproate during pregnancy. “Good evidence shows that valproate is linked to an increased risk for foetal malformations and decreased thinking skills in children, whether used by itself or with other medications,” said lead guideline author Cynthia Harden. The guidelines also state that physicians of women with epilepsy should consider avoiding the epilepsy drugs phenytoin and phenobarbital in order to prevent the possibility of decreased thinking skills in children.

Furthermore, the guidelines suggest, if possible, women with epilepsy should not take more than one epilepsy drug at a time during pregnancy since taking more than one seizure drug has also been found to increase the risk of birth defects compared to taking only one medication. In addition, the guidelines recommend women with epilepsy be warned that smoking may increase substantially the risk of premature contractions and premature labour and delivery during pregnancy.

“Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant,” said Harden. “These guidelines show that women with epilepsy are not at a substantially increased risk of having a Caesarean section, late pregnancy bleeding, or premature contractions or premature labour and delivery. Also, if a woman is seizure free nine months before she becomes pregnant, it is likely that she will not have any seizures during the pregnancy.”

However, Harden says pregnant women with epilepsy should consider having their blood tested regularly. “Levels of seizure medications in the blood tend to drop during pregnancy, so checking these levels and adjusting the medication doses should help to keep the levels in the effective range and the pregnant woman seizure free.”